U.S. patent application number 13/305952 was filed with the patent office on 2012-05-31 for system and method for workflow visualization and communication process time managment.
This patent application is currently assigned to Visual Clinic LLC. Invention is credited to Dennis McCafferty.
Application Number | 20120136679 13/305952 |
Document ID | / |
Family ID | 46127229 |
Filed Date | 2012-05-31 |
United States Patent
Application |
20120136679 |
Kind Code |
A1 |
McCafferty; Dennis |
May 31, 2012 |
SYSTEM AND METHOD FOR WORKFLOW VISUALIZATION AND COMMUNICATION
PROCESS TIME MANAGMENT
Abstract
A tracking and management system for patients in a health care
setting to improve efficiency and provide a visual office shown on
a display device. A plurality of sensors are located throughout the
health care office. The plurality of sensors can be located on
patient data record holding devices, on chairs and medical
equipment, and inside medical exam rooms. Each sensor communicates
information to a central processing unit. Sensors located on the
patient data record holding device detect the presence of an
individual patient data record in the individual patient data
record holder of the patient data record holding device and then
transmit a signal to a central processing system. The central
processing unit also receives information from an individual
patient data record processing device.
Inventors: |
McCafferty; Dennis; (York,
ME) |
Assignee: |
Visual Clinic LLC
Westford
MA
|
Family ID: |
46127229 |
Appl. No.: |
13/305952 |
Filed: |
November 29, 2011 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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61417563 |
Nov 29, 2010 |
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Current U.S.
Class: |
705/3 |
Current CPC
Class: |
G16H 10/60 20180101;
G06Q 10/06316 20130101; G16H 40/20 20180101; G06Q 10/06
20130101 |
Class at
Publication: |
705/3 |
International
Class: |
G06Q 50/24 20120101
G06Q050/24 |
Claims
1. A system for tracking and of managing patient treatment in a
health care provider office, said health care provider office
including a plurality of medical examining rooms and a plurality of
medical examination devices, said system comprising: a plurality of
patient data record holding devices, each of said plurality of
patient data record holding devices disposed at a predetermined
physical location within said health care provider office, each of
said plurality of patient data record holding devices including one
or more individual patient data record holders, each said one or
more individual patient data record holders configured for
providing a patient data record holder signal indicating an
individual patient data record has been placed in said individual
patient data record holder, each said patient data record holder
signal including an indication of time at which each said
individual patient data record was placed in a patient data record
holding device and which of said plurality of patient data record
holding devices said individual patient data record associated with
said patient data record holder signal was transmitted from; one or
more sensors disposed within each of said plurality of medical
examination rooms and each of said plurality of medical examination
devices, said one or more sensors configured for providing a signal
indicating at least whether each of said plurality of medical
examination rooms and medical examination devices are in a first
use state or in a second not in use state; at least one individual
patient data record processing device, said at least one individual
patient data record processing device configured for (a) allowing a
health-care worker to identify an individual patient utilizing
patient identification indicia included on said individual patient
data record; (b) allowing said health-care worker to identify the
next process step required by said individual patient; (c) allowing
said health-care worker to enter a health-care worker
identification code; and (d) allowing said health-care worker to
enter an indication of which of either a medical examination room
or a medical examination device is to be used for each individual
patient, and for providing an individual patient data record
processing device signal containing said individual patient
identification indicia and said health-care worker entered
information; a central processing system, configured for receiving
each said patient data record holder signal and each said
individual patient data record processing device signal, and
responsive to each said received patient data record holder signal,
for recording said time at which each said individual patient data
record was placed in said patient data record holding device and
which of said plurality of patient data record holding devices said
patient data record holder signal was transmitted from, and for
generating a listing of each patient data record holding device
including one or more individual patient data records placed
therein, said central processing system organizing said generated
listing by said indication of time at which each individual patient
data record was placed in each patient data record holding device,
for organizing said generated listing starting with the individual
patient data record that was placed in a given data record holding
device the earliest in time, and responsive to each said individual
patient data record processing device signal, storing information
contained in each said individual patient data record processing
device signal and for providing, for display, an indication of each
received individual patient data record processing device signal;
and a display device, electronically coupled to said central
processing means, and configured for displaying each said generated
listing of patient data record holding devices including one or
more individual patient data records placed therein and each said
individual patient data record processing device signal.
2. The system of claim 1, wherein said plurality of sensors
disposed within each of said plurality of medical examination are
configured for providing an indication of when said examination
room is in a not in use state; when said examination room is in an
occupied state; when said examination room is in a state identified
as occupied by a patient ready for examination by a medical
practitioner; and when said examination room is in a state
identified as patient in said examination room is being tended to
by a medical practitioner.
3. The system of claim 1, wherein at least one of said plurality of
patient data record holding devices includes one or more individual
patient data record holders associated with a programmable timer,
and wherein said central processing means records and provides an
indication of an amount of time remaining on said programmable
timer, and further were in said central processing means does not
include said individual patient data record in and organized
generated list of individual patient data records until said
programmable timer associated with said individual patient data
record has expired.
4. The system of claim 1, wherein said central processing system is
responsive to at least said plurality of sensors disposed within
each of said plurality of medical examination rooms and each of
said plurality of medical examination devices, for computing one or
more of the percentage of health-care worker utilization time; the
percentage of medical examination room utilization time, and a
cumulative individual patient wait time.
5. The system of claim 1, wherein said central processing system is
responsive to said plurality of patient data record holding
devices, said plurality of sensors disposed within each of said
plurality of medical examination rooms and each of said plurality
of medical examination devices, and said at least one individual
patient data record processing device, for computing patient
constraint analysis for providing an indication of constraint data
indicating problem areas in the health-care office.
6. The system of claim 1, further including at least one
health-care worker entry device, for providing an indication to
said system of the availability of each health-care worker for
assignment within said health-care provider office.
7. The system of claim 6, wherein said central processing system
includes a data base containing information including one or more
of: one or more skills possessed by one or more health-care
workers; accessibility by disabled individuals to one or more
medical examination rooms; and one or more factors to be considered
in providing the best, easiest and most timely medical care to each
individual patient.
8. The system of claim 6, wherein said central processing system
provides information concerning any patient visit to workflow
constraint caused by a physical facility constraint, a clinical
resource constraint or a combination of both a clinical resource
and facility constraint.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims priority from U.S. Provisional
Patent Application No. 61/61/417,563 titled "System And Method For
Workflow Visualization And Communication Process Time Management"
filed on Nov. 29, 2010 and incorporated fully herein by
reference.
TECHNICAL FIELD
[0002] The present invention relates to a system and method for
tracking and managing resources utilized in providing patient
treatment in a health care setting using a plurality of sensors, a
central processing system with a display and patient data record
processing.
BACKGROUND INFORMATION
[0003] All healthcare providers including, for example only,
Ophthalmologists, are facing challenging market trends. Demand for
medical services is growing rapidly due to population growth and
aging while the number of practicing physicians is roughly static.
New doctors graduating and entering the work force are expected to
just compensate for those older doctors retiring and leaving the
work force. One would expect rising demand for medical services
which are limited in supply to result in higher prices.
Reimbursement rates for medical services, however, are not rising,
but rather they are falling. The growing demand for medical
services is not only exceeding provider capacity but is exceeding
the public and private funds available to pay for them. There are
limitations on public and private resources available for funding
medical services. Although patients have less money to pay and
fewer doctors available to them, patients are becoming more
demanding in terms of quick access, speedy appointments and pricing
discounts.
[0004] These conditions dictate that physicians must see more
patients, process them without delay, and expect less compensation
for their services. The necessary increase in capacity and
operating efficiency can only be achieved through increased
leverage of the professional medical staff's time, resources and
equipment.
[0005] Several industries were faced with similar challenges in the
preceding decade. For example, the chemical industry, automotive
manufacturing, and electronics manufacturing industries experienced
extended periods of falling prices, rising costs and an unrelenting
consumer demand for higher quality and shorter lead times. Despite
these daunting challenges many firms have flourished. Their success
is widely attributed to the adoption of Lean Manufacturing, the
Toyota Production System (TPS), and Six Sigma techniques.
[0006] There are several key concepts at the center of these
systems. First, a single piece flow that avoids batching. Second, a
production rate set to match the Takt time (or cadence) of customer
demand in order to avoid the waste of delays and the waste of
overproduction. Third, a pace-setter operation that is identified
and optimized for processing time, which is usually the scarcest
resource. Fourth, all supporting process steps must be defined and
work balanced to deliver a single piece at the same time interval
as the pacesetter operation, often called work leveling. Fifth, a
visual workplace, which is self-explaining, self-ordering and not
reliant on verbal communication to initiate actions. Sixth, the
system is process focused, meaning that all work is viewed as a
collection of processes. Each process is defined and has
quantifiable standards for inputs and outputs, each of these inputs
and outputs is measured and process control feedback loops are
employed to initiate corrective actions to keep the process under
control and operating within control limits.
[0007] These same systems and methods offer opportunity and hope to
healthcare providers. Some healthcare organizations have already
begun to deploy them. The challenge is how to adapt these tools and
methods from a manufacturing production process to a medical
services process.
[0008] In a clinical services environment, the physician
examination is the pace-setter step. This pace-setter time
increment can be referred to as the takt time or process cadence.
As a doctor can exam only one patient at a time, the upstream
processes must advance the next patient (ready for examination)
within the takt time. Failure to advance a patient leaves the
doctor idle and creates waste (capacity loss). Advancing more than
one patient leaves the patient idle and creates waste (patient wait
time). To achieve consistent single patient flow, the pace-setter
takt time must be known with statistical precision and all
supporting processes must be organized into logical segments
time-balanced to this time increment.
[0009] There are many existing problems with synchronous single
patient flow used in medical offices. First, delays or work
stoppages cascade through the system and are magnified due to
interdependence and leverage. There are cumulative capacity losses.
There is a cumulative effect on patient visit times. Slack time
that is created through work balance and leveling represents added
cost if the slack time is not utilized for other necessary
"offline" clinical tasks.
[0010] Most manufacturing operations employ electronic industrial
equipment. From this equipment process data concerning inputs and
output, particularly process cycle times can be readily captured.
This data can then be aggregated and analyzed against standards.
Deviations can then be communicated through feedback loops for
correction. In the medical services setting there is no such
infrastructure or platform from which to capture process data. The
majority of medical practices still employ manual paper systems.
Electronic medical records (EMR) systems where deployed lack the
capability to accurately and reliably provide process data.
[0011] Therefore, what is needed is a system that is capable of
increasing capacity resulting in better leveraging of the Doctor's
time, thereby creating higher revenue for the provider and practice
and faster access to care for the patients. The system should
reduce all waste, including both the waste of waiting and the waste
of overproduction. The system should also improve patient
satisfaction with visit times by eliminating long delays due to
patient bunching and providing for predictable visit times.
SUMMARY
[0012] The present invention features a system for tracking and of
managing patient treatment in a health care provider office, the
health care provider office including a plurality of medical
examining rooms and a plurality of medical examination devices. The
system comprises a plurality of patient data record holding
devices, each of the plurality of patient data record holding
devices disposed at a predetermined physical location within the
health care provider office. Each of the plurality of patient data
record holding devices includes one or more individual patient data
record holders, each of the one or more individual patient data
record holders is configured for providing a patient data record
holder signal indicating an individual patient data record has been
placed in the individual patient data record holder. Each patient
data record holder signal includes an indication of a time at which
each individual patient data record was placed in a patient data
record holding device and which of the plurality of patient data
record holding devices the individual patient data record
associated with the patient data record holder signal was
transmitted from.
[0013] Also included in the system is one or more sensors disposed
within each of the plurality of medical examination rooms and each
of the plurality of medical examination devices. The one or more
sensors are configured for providing a signal indicating at least
whether each of the plurality of medical examination rooms and
medical examination devices are in a first use state or in a second
not in use state.
[0014] The system further includes at least one individual patient
data record processing device. The at least one individual patient
data record processing device is configured for (a) allowing a
health-care worker to identify an individual patient utilizing
patient identification indicia included on the individual patient
data record; (b) allowing the health-care worker to identify the
next process step required by the individual patient; (c) allowing
the health-care worker to enter a health-care worker identification
code; and (d) allowing the health-care worker to enter an
indication of which of either a medical examination room or a
medical examination device is to be used for each individual
patient, and for providing an individual patient data record
processing device signal containing the individual patient
identification indicia and the health-care worker entered
information.
[0015] The system further includes a central processing system,
which is configured for receiving each of the patient data record
holder signals and each of the individual patient data record
processing device signals, and responsive to each of the received
patient data record holder signals, recording the time at which
each the individual patient data record was placed in the patient
data record holding device and which of the plurality of patient
data record holding devices the patient data record holder signal
was transmitted from. The central processing system then generates
a listing of each patient data record holding device, including one
or more individual patient data records placed therein. The central
processing system organizes the generated listing by the indication
of time at which each individual patient data record was placed in
each patient data record holding device, in order to organize the
generated listing starting with the individual patient data record
that was placed in a given data record holding device the earliest
in time. The central processing system is responsive to each
individual patient data record processing device signal, storing
information contained in each individual patient data record
processing device signal and providing, for display, an indication
of each received individual patient data record processing device
signal.
[0016] The present invention further includes a display device,
which is electronically coupled to the central processing system.
The display device is configured for displaying each generated
listing of patient data record holding devices including one or
more individual patient data records placed therein and each
individual patient data record processing device signal.
[0017] The system may further include a plurality of sensors
disposed within each of the plurality of medical examination that
are configured for providing an indication of when the examination
room is in a not in use state; when the examination room is in an
occupied state; when the examination room is in a state identified
as occupied by a patient ready for examination by a medical
practitioner; and when the examination room is in a state
identified as patient in the examination room is being tended to by
a medical practitioner.
[0018] In another embodiment, at least one of the plurality of
patient data record holding devices includes one or more individual
patient data record holders associated with a programmable timer,
and wherein the central processing means records and provides an
indication of an amount of time remaining on the programmable
timer, and further were in the central processing means does not
include the individual patient data record in and organized
generated list of individual patient data records until the
programmable timer associated with the individual patient data
record has expired.
[0019] In a further embodiment, the central processing system is
responsive to at least the plurality of sensors disposed within
each of the plurality of medical examination rooms and each of the
plurality of medical examination devices, for computing one or more
of the percentage of health-care worker utilization time; the
percentage of medical examination room utilization time, and a
cumulative individual patient wait time.
[0020] In yet another embodiment, the central processing system is
responsive to the plurality of patient data record holding devices,
the plurality of sensors disposed within each of the plurality of
medical examination rooms and each of the plurality of medical
examination devices, and the at least one individual patient data
record processing device, for computing patient constraint analysis
for providing an indication of constraint data indicating problem
areas in the health-care office.
[0021] The present invention may also further include at least one
health-care worker entry device, for providing an indication to the
system of the availability of each health-care worker for
assignment within the health-care provider office.
[0022] The central processing system may include a data base
containing information including one or more of: one or more skills
possessed by one or more health-care workers; accessibility by
disabled individuals to one or more medical examination rooms; and
one or more factors to be considered in providing the best, easiest
and most timely medical care to each individual patient.
[0023] In an additional embodiment of the present invention, the
central processing system provides information concerning any
patient visit to workflow constraint caused by a physical facility
constraint, a clinical resource constraint or a combination of both
a clinical resource and facility constraint.
[0024] Although the present invention will be explained in the
context of an ophthalmology practice, it is important to note that
the present invention is not intended to be limited to a system or
method which must satisfy one or more of any stated objects or
features of the invention. The ideas and features disclosed in the
invention can be implemented and practiced equally as well in other
medical practices, albeit reconfigured or adapted for the
particular practice needs. It is also important to note that the
present invention is not limited to the preferred, exemplary, or
primary embodiment(s) described herein. Modifications and
substitutions by one of ordinary skill in the art are considered to
be within the scope of the present invention.
BRIEF DESCRIPTION OF THE DRAWINGS
[0025] These and other features and advantages of the present
invention will be better understood by reading the following
detailed description, taken together with the drawings wherein:
[0026] FIG. 1 is a block diagram of a system for tracking and
managing patient treatment in a health care provider office,
according to one embodiment of the present invention;
[0027] FIG. 2 is a detailed schematic view of a system for tracking
and managing patient treatment in a health care provider office,
according to one embodiment of the present invention;
[0028] FIG. 3 is a detailed view of the patient flow process
according to one embodiment of the present invention;
[0029] FIG. 4 is a detailed grid view of a patient flow time
according to one embodiment of the present invention;
[0030] FIG. 5 is a detailed view of the visual process flow
communication according to one embodiment of the present
invention;
[0031] FIG. 6 is a detailed view of a check-in station for patient
charts, according to one embodiment of the present invention;
[0032] FIG. 7 is a detailed view of a chart docking station,
according to one embodiment of the present invention;
[0033] FIG. 8 is a flow chart illustrating a process constraint
logic analysis which may be carried out by the system of the
present invention;
[0034] FIG. 9 is an exemplary report from the system of the present
invention in the form of a graph reporting on the number of patient
workups and average patient workup times for each of a number of
clinicians;
[0035] FIG. 10 is an additional exemplary report from the system of
the present invention in the form of a chart illustrating
cumulative minutes that patients waited for workup by a clinician;
and
[0036] FIG. 11 is yet another exemplary report from the system of
the present invention in the form of a graph illustrating
cumulative average patient workup times for all clinicians
combined.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0037] The present invention features a tracking and management
system 10, FIG. 1, for patients in a health care setting. The
tracking and management system includes a plurality of sensors 24.
Each patient 42 has an individual patient data record 22 associated
with the patient. The individual patient data record 22 is tracked
throughout the visit through a plurality or series of patient data
record holding devices 16 that feature one or more individual
patient data record holders 18. Each patient data record holding
device 16 includes one or more sensors 24 (for example, 24a, 24b,
24c, etc.). An exemplary data record holding device is a file
folder equipped with one or more sensors 24. The sensors 24 detect
the presence of an individual patient data record 22 in the
individual patient data record holder 18 of the patient data record
holding device 16, and then transmit a "patient data record
present" signal 20 to a central processing system 40.
[0038] The tracking and management system 10 also uses additional
sensors 24 to track and monitor people and items within the health
care office. For example, a sensor 24f may be attached to a chair
in an examination room. This sensor 24f is designed to detect the
presence or absence of a person who is sitting in the chair. A
sensor 24e can also be used in the room and this type of sensor may
be a motion sensor, which is designed to detect the presence of
movement in the medical office, either by a patient or by a health
care provider. Another sensor 24g may be physically connected to a
medical exam device 14. The medical exam device 14 can be any
equipment or material used by a medical professional. The sensor
24g attached to the medical exam device 14 indicates the use or
non-use of the medical exam device 14. All of the sensors 24
communicate with the central processing system 40.
[0039] The tracking and management system 10 further includes at
least one individual patient data record processing device 30. The
individual patient data record processing device 30 communicates
with the central processing system 40 through the use of an
individual patient data record processing device signal 32. The
individual patient data record processing device 30 allows a health
care worker to identify an individual patient using a patient
identification mark or indicator (not shown) included on the
individual patient data record 22. The individual patient data
record processing device 30 allows the health care worker to
identify the next process step required by each individual patient.
The individual patient data record processing device 30 also allows
the health care worker to enter a health care worker (user)
identification code.
[0040] The health care identification code can be any identifier
that specifically identifies one health care worker from another
health care worker, such as password, employee ID, or other
identifier. Additionally, the individual patient data record
processing device 30 allows the health care worker to enter an
indication of which medical exam room 12 and any medical exam
devices 14 are to be used for any individual patient. All of the
information entered about the individual patient and about the
health care worker is transmitted to the central processing system
40 via the individual patient data record processing device signal
32. Examples (without limitation) of patient data record processing
devices 30 includes a keyboard, touchpad, scanner, and the
like.
[0041] In use, a health care worker 44 determines the next patient
42 in queue and ready for service as described herein and takes the
individual patient data record 22 representing the next patient in
the patient data record holding device 16 and moves the patient
into a work step. The state of all hard assets such as medical exam
rooms 12 and medical equipment or medical exam devices 14 is known.
This is achieved by monitoring several sensors 24 located at each
room and with various equipment. One such sensor 24e is a motion
sensor designed to detect human presence in a medical exam room or
other room. If no human presence is detected the room is considered
to be state zero or "Not in Use". This provides knowledge to the
tracking and management system 10 and health care works 44 as to
where to bring the next patient 42 for service.
[0042] Medical exam rooms may have additional states for
communicating activity and process status. For example, the
following states are possible: State 0--Exam room not in use; State
1--Exam room occupied; State 2--Exam room patient ready for doctor;
State 3--Exam room doctor exam in progress. Medical exam room
states will vary based on the office size and practice type. By
monitoring the medical exam room states, important system
productivity data can be measured, such as Doctor time utilization
(% of total time in state 3), Room utilization (% of time not in
state 0), Cumulative Patient wait time at this process step (% of
time in state 2) as well as other system productivity data.
[0043] The central processing unit 40 also receives information
from an input device 48. Examples of input devices include data
entry keyboards, mouse, touchpad and the like. The input device 48
allows a health care worker, receptionist, or another employee (or
perhaps the patient as well if the office practice depends on a
patient self registering, for example) to enter any data or
information necessary to create patient records, to make notes of
patient preferences, or any other information. The central
processing unit 40 that is comprised of appropriate processing
hardware running appropriate computer software receives all of the
signals (20, 26, 28) from the various sensors 24, and records the
signals and their times.
[0044] For example, the central processing device 40 receives a
signal 20 from the sensor 24a of the patient data record holding
device 16 indicating that an individual patient data record 22 has
been placed into an individual patient data record holder 18. The
central processing unit 40 records the exact time that the
individual patient data record 22 enters the individual patient
data record holder 18 and subsequently will record the time that
the individual patient data record 22 remains in the individual
patient data record holder 18, this recording of time ending when
the individual patient data record 22 is removed from the
individual patient data record holder 18.
[0045] The central processing unit 40 is capable of generating a
list of each patient data record holding device 16 that includes
one or more individual patient data records 22 and then generating
a listing that is compiled based on the entry time of each
individual patient data record 22 into each patient data record
holding device 16. The listing can be relative to each patient data
record holding device 16 individually or can combine one or more
patient data record holding devices 16 into a single list. The
lists begin with the individual patient data record 22 that was
placed in the patient data record holding device 16 earliest in
time.
[0046] For example, at check-in 36, a patient data record holding
device 16 may include one or more individual patient data records
22, FIG. 7. As each individual patient data record 22 is placed
into an individual patient data record holder 18 of the patient
data record holding device 16, a patient data record holder signal
20 is sent to the central processing unit 40. The central
processing unit 40 organizes the individual patient data records 22
into a list using a first in, first out priority system, with the
earliest being first on the list. The sensor 24, which may also be
referred to as a proximity switch, senses the presence of the
patient chart or record. The patient data record holding device 16
may also include a priority re-order button 52, which allows for a
manual override of the first in, first out system. The priority
re-order button 52 can be pressed, thereby moving the individual
patient data record 22 to an earlier position in the list.
[0047] The patient data record holding device 16 may also feature a
lighting system or one or more status indicator lights 50. The
status indicator lights 50 are designed to indicate the patient
status. For example, a green light would indicate that the patient
is ready for the next step and that the patient is first on the
list or queue. A red light would indicate that the patient is not
ready for the next step in the process. The status indicator lights
50 may include other colors or various patterns, such as flashing,
to signal any number of various status possibilities. The patient
data record holding device 16 may also include a display screen 54.
The display screen 54 may be an LCD display or another type of
display. The display screen 54 may include graphics and/or text,
which can display any information pertinent to the medical office
and/or the health care workers, such as room use assignment, the
doctor using the room today, and any other messaging.
[0048] In one embodiment, the tracking and management system 10 is
designed to be used in a medical office, FIG. 2. This tracking and
management system 10 preferably includes multiple patient data
record holding devices 16. For example, a first patient data record
holding device 16 may be present at check-in, a second patient data
record holding device 16 may be present outside a first medical
exam room 12a, a third patient data record holding device 16 may be
outside a second medical exam room 12b, and a fourth patient data
record holding device 16 may be at check-out 38. Each patient data
record holding device 16 may feature one or more individual patient
data record holders or "positions" 18. For example, the waiting or
check-in area 36 will preferably feature a patient data record
holding device 16 that includes a plurality of individual patient
data record holders 18, while each medical exam room 12 would
feature a patient data record holding device 16 with a single
individual patient data record holder 18.
[0049] The tracking and management system 10 of this embodiment
features a plurality of sensors 12, located on patient data record
holding devices 16, located within medical exam rooms 12, attached
to medical exam devices 14 or to other objects, such as chairs. The
sensors transmit information to the central processing unit 40. An
incoming patient 42 can proceed to check-in 36 and through any
various needed medical exam rooms (12a, 12b, etc.) and then to
check-out 38.
[0050] The patient flow process, FIGS. 3 and 4, details the process
steps that are designed to advance one patient within the takt time
or cadence time. In this embodiment, an example of a patient eye
examination is used to show a detailed view of how the tracking and
management system 10 can be used during a patient visit. A patient
visit includes multiple process segments, including arrival, a work
up with one more technicians, various testing, a timed dilation
component that includes a waiting period, a doctor examination as
well as a checkout process. The tracking and management system 10
is designed around creating an efficient and profitable office
centered around the takt time, which is the pace setting step in
the process.
[0051] Each process segment is organized and time balanced to the
doctor examination takt time. A detailed view of the process
segments, FIG. 4, illustrates the sequential steps and the
interdependence of each provider on the overall execution and
performance of the tracking and management system 10. The tracking
and management system 10 is able to show workload balancing by
process segment. For example, the tracking and management system 10
can show various parameters, including but not limited to
value-added face time spent with a patient and worker slack time.
Each parameter can be shown in the grid view using a different
color or pattern.
[0052] The present invention is designed to create a workflow
visualization and communication system, essentially a visual
clinic. The central processing system 40 uses a series of one or
more display devices 46. The display devices 46 display information
output, such as the priority lists generated by the central
processing system 40, to the health care workers in the office. The
display devices are typically a computer type screen or monitor or
can be a television screen, such as an LCD, plasma or projection
screen. In a preferable embodiment of the present invention, a
plurality of display devices 46 are located throughout the health
care office, providing health care workers with easy access to view
the information.
[0053] For example, as the system has knowledge of a) a patient
waiting for a specific service; b) the availability of all workers
capable of performing that service; and c) the availability of the
medical exam room or medical exam device or equipment needed to
provide the service, the tracking and management system 10 becomes
capable of creating efficiency. For example, the tracking and
management system 10 presents preferential queuing with two-way
communications, thereby directing service tasks to the most
advantageous worker currently available and to the equipment/room
most effective for providing the service. When the individual
patient data record 22 is placed in the patient data record holding
device 16, the health care worker 44 that is placing the individual
patient data record 22 may select any special requirements for this
patient. For example, a bilingual healthcare worker or wheelchair
access, or any other special requirements. The tracking and
management system 10 would then notify first the most preferred
health care worker that is bilingual. The tracking and management
system 10 would also instruct the health care worker to choose a
medical exam room that has the best accommodations for wheel chair
service. If no special accommodations are necessary, the service
would be directed to the overall most preferred worker. The
preference could be based on best productivity or it could be based
on a distribution scheme for ensuring all service providers see an
equal amount of patients or any other distribution mechanism as
determined by the health care office. When a health care worker is
assigned an individual patient data record 22, the icon on the
display device 46 will display that health care worker's initials
or another identifying mark.
[0054] A health care worker that is notified of an individual
patient data record 22 assignment through the notifier popup
message system is able to confirm or "claim" the patient by
clicking on the chart icon 62 on the display device 46. From the
time the individual patient data record 22 has been assigned until
the time it is "claimed" the chart icon 62 on the display device 46
is displayed with the assignee initials but in a state that
designates that it has not been acknowledged and "claimed". Once
"claimed" the icon appearance will change to reflect that it is now
confirmed and "claimed". The tracking and management system 10
provides constraint data for determining the bottlenecks in the
service process.
[0055] The process provides specific process data for use in
commercial process improvement simulation. Commercial process
improvement simulation software programs require process data in
the format of a) frequency distribution of process cycle times by
process step and b) the probability that the resources needed for
the next process step will be available. For example, to create a
simulation model for patient process times for work up the
following data must be known a) work up cycle time in frequency
distribution format, not simple averages; and b) probability that a
worker and/or room will be available when a chart or card reaches
the queue station for workup. The tracking and management system 10
is uniquely able to provide this data in a format that can be used
directly for simulation studies for process improvement.
[0056] The information generated by the central processing system
40 and shown on the display devices 46 provides the tools to remove
delays in processing patients and utilize system slack time for
productive offline tasks. Visual communications are the key. Visual
cues indicating patient status tell nurses and technicians when a
patient is ready for the next step in the process. These are
analogous to the Kanban cards used in Lean Manufacturing
operations. Visual status on room and equipment availability tells
them where to perform this work. Visual status of the entire clinic
(patients, rooms and equipment) enhances the physician's decision
making on whether to order same-day tests or when to step out for
important tasks such consult phone calls, consultation letters,
etc.
[0057] The check-in process of the tracking and management system
10, FIG. 5, includes a check-in and chart up station 60, FIG. 6,
for each individual patient data record 22. In this embodiment,
each individual patient data record 22 is placed onto a surface 56,
such as a table or shelf. The surface 56 includes a plurality of
sensors 24 located along a side of the surface 56. Each sensor 24
registers the presence of an individual patient data record that is
located at the pick up station. The sensor 24 then transmits the
reception of an individual patient data record 22 via a patient
data record holder signal 20 to the central processing unit 40,
including a time associated with the placement. The surface 56 may
be labeled with one or more place holders or identifiers 58, which
may include specifics about the health care worker who is
designated to handle a particular patient data record 22, such as
Dr. A, Dr. B, Technician 1, Technician 2, etc.
[0058] The check-in and chart up station 60 is designed to improve
communication. The check-in and chart up station 60 sends signals
to the central processing unit 40, which in turn notifies a doctor
or technician that there is patient 42 who has checked in,
completed their preregistration and is now is ready to begin their
examination. This notification occurs by display of the information
on the display devices 46. Software that runs on the central
processing system 40 is designed to acknowledge the sensor status
and light up a chart icon on the display device 46 as well as
creating a pop up message for the health care worker at their
designated computer workstation or at another computer based
display, such as a smartphone or tablet.
[0059] The tracking and management system 10 accomplishes
communication objectives by allowing health care workers to
communicate at a glance 1) the next patient to be seen; and b) what
the next process step is for that patient. For example, in an
ophthalmology setting, the sensors 24 register the presence of an
individual patient data record 22 in an individual patient data
record holder 18 of the patient data record holding device 16. Each
individual patient data record holder 18 has a programmable
dilation delay timer. Individual patient data record holders 18
assigned to "No Dilation Required" have the timer set to zero
seconds. Slots assigned to "Dilation Required" have the timer set
to the average dilation time (15 minutes would be typical).
[0060] The software of the central processing device 40 monitors
the sensor status of each sensor 24 and creates a visual clinic
shown on the display device 46, FIG. 5. When an individual patient
data record 22 is placed in a patient data record holding device 16
(see FIG. 7) a chart icon 62 appears on the display device 46 in
that patient data record holding device 16 position. When that
individual patient data record 22 reaches the top of the queue the
slot status light turns green 50 on the docking station (16 or 60)
and on the display device 46. A pop up message is then sent to the
clinician at their designated computer workstation or to their
computer base device communicating the need to take action.
[0061] The check-in chart docking station 60, when used in an
ophthalmology setting, facilitates the efficient movement of a
patient from one process step to the next where there is a) a
planned time delay (dilation time for eye exam) or b) a different
clinician assigned to the next process step. The check-in station
60 segregates patients requiring dilation delay from those that can
advance immediately to next step. Charts placed in the section "No
Dilation Required" enter immediately into the queue. The dilation
section is configured with a programmable timer. When a chart is
placed in "Dilation Required" section the indicator for that slot
immediately turns red. After the timer set point is reached the red
light is turned off and the patient is entered into the queue. The
queue logic is first in-first out.
[0062] The patient chart next in queue is highlighted by a green
inidicator light. While more than one patient may be ready for the
next step, only the chart at the top of the queue is green. If a
clinician determines that the patient priority should change they
are able to overide the first in-first out logic and move any chart
to the top of the queue by pressing the priority re-order button 52
provided for that individual patient data record holder 18. Chart
docking stations are deployed, for example, at the following
process points: pre-testing and exam ready.
[0063] In one embodiment, a Doctor alternates between two exam
rooms. The presence of an individual patient data record 22 in the
patient data record holding device 16 indicates to the Doctor or
other health care worker that the patient is in the room and is
ready to be seen. If there is a chart present at more than one room
a colored indicator light 50 tells the doctor or health care worker
which patient to see first. Indicator lights 50 work off of first
in/first out logic. When an individual patient data record 22 is
placed in the patient data record holding device 16 a sensor 24
registers its presence. The software of the central processing
system 40 records the time of placement and begins an elapsed time
counter. The central processing system 40 compares the time of each
individual patient data record 22 within one or more single patient
data record holding devices 16. The individual patient data record
22 that has the longest elapsed time (or that was the first to
enter the patient data record holding device 16) is first. All
other individual patient data records 22 are set in the order of
entry.
[0064] The time based queue can be over-ridden. A Doctor, nurse or
other health care worker 44 may move any patient 42 to the top of
the queue by pressing the Priority Re-order button 52 for that
medical exam room 12. Communications to the doctor that a patient
is now ready are accomplished by: Status change on internal web
browser. A chart icon 62 appears on a display screen 54 in front of
the medical exam room 12 and the elapsed time counter is displayed
in real time. A pop up message is sent to the doctor's designated
office computer or other communication device. A text message,
email or other notification is sent to doctor's smart phone or
pager.
[0065] The present invention provides the means to collect,
calculate, analyze and graphically view process time information.
This process enables:
[0066] Design validation: Confirmation that work breakdown is in
balance and supports process segment times at the designated takt
time.
[0067] Analysis of variation: Provides statistical information
about process variations as a function of 1) Appointment type; 2)
individual performers (technician, scribe, and doctor).
[0068] Reaction to anomalies: Provides Andon notification when a
patient visit time exceeds control limits.
[0069] Overall Visit Times Conformance Trending: Measures
performance to office visit times standards.
Analysis of Variance
Dependent Variables: Process Segment Times
[0070] Overall Visit Times [0071] % of Office Visits Conforming to
STD Time
Independent Variables Appointment Reason
[0071] [0072] Patient Age [0073] Patient Medical Condition
Complexity Work up Technician assigned [0074] Scribe Nurse assigned
[0075] Doctor [0076] Time of day [0077] Day of week
[0078] as shown for example in the logic chart 100 of FIG. 8, the
present invention allows the central processing unit to gather
statistical information and provide to the system administrator
process constraint as shown, for example, in the process constraint
logic chart 100. In this manner, the facility or system
administrator is able to look back on statistical information to
determine whether there is a facility constraint (additional
examination rooms or exam equipment is required) or whether
additional clinicians or other staff members are required.
[0079] The recorded process data is used to identify statistical
relationships and causes of variation in the process. Six Sigma
methods such as regression, one-way ANOVA, run charts, I-MR charts,
U charts are used. The process details actual process time stamps
and segment time durations, as well as process segment time
averages based on appointment type and patient visit percent
conformance process time standard, among other process time
results. A process control system warning allows anomalies to be
quickly addressed. As soon as the "actual" process time exceeds a
predetermined "standard" process time control limit, a popup
message or other notification or alert is sent to the computer
based device (cell phone for example) of the health care worker or
the staff member responsible for process monitoring and corrective
actions. In this way, actual process times can be identified
rapidly and real-time and addressed. Actual performance process
times can be charted over days, weeks, months or any other
timeline.
[0080] Other notable features of the present invention include
playback capability, such that a snapshot of all asset and resource
states are captured and logged in a database file at preprogrammed
time intervals. A typical time interval would be 10 to 30 seconds
apart. This historical data may then be played back through the
device display at a preselected accelerated speed. A typical
accelerated speed would be 15:1. The present invention can also
determine the presence, number of and identity of health care
workers in a room or location through voice recognition of through
the use of skeletal frame dimensions as determined by IR light
scanning techniques.
[0081] In addition, an almost unlimited number of reports and data
analysis displays may be provided as desired and selected by the
system administrator/user as shown, for exemplary purposes only, in
FIGS. 9 through 11.
[0082] Accordingly, the present invention provides a system and
method for gathering information about a process and procedure and
for optimizing this process or procedure utilizing a visual display
system incorporating elements of both hardware and software to
indicate to the process providers not only the status of the
process but also the next step in the process, allowing the process
provider(s) to immediately know what step is next in the process
and whether any delays or variation in the process are occurring or
need to occur.
[0083] It is important to note that the present invention is not
limited to the preferred, exemplary, or primary embodiment(s)
described herein. Modifications and the substitutions by one of
ordinary skill in the art are considered to be within the scope of
the present invention, which is not to be limited except to the
allowed claims and their legal equivalents.
* * * * *